The first cases of H1N1 infection resistant to oseltamivir (Tamiflu) spreading from person-to-person were found in Wales last week. The spread of the resistant strain occurred at the University Hospital of Wales in Cardiff and all five people affected have “severe underlying health conditions” according to officials.

Dr Roland Salmon, Director of the NPHS Communicable Disease Surveillance Centre, said: “The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment.” more…

New guidelines on the management of pandemic H1N1 influenza were published recently by the Department of Health. They include guidelines on when to refer patients to hospital (see below) and an update on the epidemiology of the disease: fewer than 1% of cases are admitted to hospital; 12-15% of patients admitted to hospital go on to need high dependency or critical care; and mortality for hospitalised adults is around 6%. more…

The H1N1 vaccination programme is underway in the UK and many other countries across the globe. In Sweden a million people have already been vaccinated. One swine flu vaccine manufacturer, GlaxoSmithKline, expects to produce 440 million doses over the next few months. With newspapers, television and the internet raising doubts about the safety of the vaccine, many doctors will be consulted by anxious patients wanting to know whether the vaccine is safe and effective. more…

The swine flu vaccine is officially here. The UK government announced on Friday that over 400,000 doses of the swine flu vaccine will be delivered to hospitals this week. The first to get the jab (from Wednesday) will be hospital inpatients belonging to at-risk groups and hospital staff. Next week GPs are due to start vaccinating patients according to their priority status, which are as follows (top priority first): people aged six months to 65 years with underlying health problems and the immuno-suppressed; pregnant women; household contacts of people with compromised immune systems; people aged over 65 with health problems. The Daily Mail are characteristically concerned about the vaccine, in particular its use in children. more…

England’s chief medical officer Sir Liam Donaldson can sound gloomy and pessimistic but he sounded very upbeat in this week’s swine flu update, saying: “We may have got a lucky break in how the virus has behaved at the start of our flu season and we may be able to get the vaccine out there before our flu season really gets under way. I’m looking at it very optimistically.” more…

The BBC trailed it as everything you need to know about swine flu. The title probably raised my expectations too high.

A street poll near the start of the programme showed that the public were a bit confused about who was at the most risk of swine flu, so it seemed the programme had some scope to educate viewers; and it did feel a bit like a government broadcast, or a school education film. Three presenters travelled the world to “expose the myths and the dangers of swine flu,” interviewing “swine flu survivors and the relatives of its young victims”. more…

PLOS Currents: Influenza is a journal with a difference. Mixing features of a journal with those of blogs and discussion forums it’s bound to ruffle some feathers. It describes itself as “a moderated collection for rapid and open sharing of useful new scientific data, analyses, and ideas.” Contributions are not peer reviewed other than for intelligibility, relevance and suitability. You can rate and comment on submissions and see how many other people have read them. Is this the future of research or a dangerous drop in standards? more…

Two swine flu call centres in England will close on Sunday with the loss of 1200 jobs reports The Guardian. Demand for Tamiflu has plummeted: it peaked on 27 July with nearly 39,000 authorisations for the use of Tamiflu while on 16 August there were only 3396. According to the HPA there were only 11,000 new cases of swine flu last week and the GP consultation rates have dropped from a peak of 35 consultations per 100,000 of the population to under 5 (similar to the rate in January this year for seasonal flu). 59 people in the UK are reported to have died from the virus so far. more…

Is there anything new about swine flu?

The Department of Health update revealed an interesting finding this week. The Guardian reports;

“One of the odder aspects of the latest data is that only 10% of those who sought help from a GP or the National Pandemic Flu helpline and subsequently took a swab test actually showed signs of infection.” more…

Last week we learnt who will be offered the vaccine against swine flu first. Priority groups include people in high risk groups age between 6 months and 65 years, pregnant women, household contacts of immune-compromised people, and clinical staff. more…